Climatic variations and pollution on benign paroxysmal positional vertigo in Kars, Türkiye.

Benign paroxysmal positional vertigo (BPPV) is the most common diagnosis for peripheral vertigo. Although pathophysiological mechanisms remain unclear, BPPV is mostly idiopathic and factors related to BPPV are still being investigated. Knowing these factors can contribute to the prevention and management of BPPV. In this study, we investigated the correlations between climatic variations, pollution, and BPPV retrospectively. 262 patients diagnosed with BPPV between 2019 and 2021 in Kars, Türkiye, were included in our study. Meteorological parameters were obtained from Turkish State Meteorological Service. Horizontal BPPV increased significantly with the humidity (p < 0.05). In addition, carbon monoxide levels significantly increased the potantial of BPPV (p < 0.05). Surprisingly, BPPV increased in the summertime and showed a significant relationship with humidity. We believe this change is related with the city-specific features as it is the coldest place in the country, emigrant province and crowded in the summer times.

Evaluation of the diagnosed incidental diabetes mellitus in patients with hyperglycaemia in the emergency department.

BACKGROUND: This study was conducted to determine the frequency and clinical features of patients who were diagnosed incidentally as having diabetes mellitus (DM) in the emergency department. AIM: Our aim was to investigate the ratio of DM in patients whose high blood glucose levels (hyperglycaemia) were detected, and to examine the subsequent treatment for these patients. METHODS: The participants were selected from among patients who had a glucose level of ≥200 mg/dL and admitted to emergency department with symptoms of hyperglycaemia in the past one year. Age, gender, presence of chronic disease and the laboratory blood parameter results of the patients were recorded. We divided the patients into three groups as those who had never been admitted to clinics for treatment, those who were admitted and given treatment and not given treatment. RESULTS: According to their genders, 73 (52.1%) were male and 67 (47.9%) were female. It was determined that 86 of the 140 patients included in the study were admitted to clinics for control. It was determined that no medication was given to 50 of these patients, but treatment was initiated in 36. Patients with glucose level ≥300 mg/dL were found to be receiving more treatment significantly (P = .031). There were significantly fewer patients with renal disease in the group in which medication was initiated than in the group for which medication was not initiated. CONCLUSIONS: Patients with blood sugar ≥200 mg/dL in the emergency department should be sent to the DM outpatient clinic. It was observed that regular drug use after the diagnosis of DM had a protective effect on renal disease.

The effects of resistant starches on inflammatory bowel disease in preclinical and clinical settings: a systematic review and meta-analysis.

BACKGROUND: Inflammatory bowel disease (IBD) is a debilitating chronic disease with limited treatment options. Resistant starches may represent a novel treatment for IBD. However, its efficacy and safety remain unclear. Our objective was to perform a systematic review to summarize the preclinical and clinical effects of resistant starch, which may help guide future studies. METHODS: Medline, EMBASE, and the Cochrane Central Register were searched. Included studies investigated the use of resistant starch therapy in in vivo animal models of IBD or human patients with IBD. Articles were screened, and data extracted, independently and in duplicate. The primary outcomes were clinical remission (clinical) and bowel mucosal damage (preclinical). RESULTS: 21 preclinical (n = 989 animals) and seven clinical (n = 164 patients) studies met eligibility. Preclinically, resistant starch was associated with a significant reduction in bowel mucosal damage compared to placebo (standardized mean difference - 1.83, 95% CI - 2.45 to - 1.20). Clinically, five studies reported data on clinical remission but clinical and methodological heterogeneity precluded pooling. In all five, a positive effect was seen in patients who consumed resistant starch supplemented diets. The majority of studies in both the preclinical and clinical settings were at a high or unclear risk of bias due to poor methodological reporting. CONCLUSIONS: Our review demonstrates that resistant starch is associated with reduced histology damage in animal studies, and improvements in clinical remission in IBD patients. These results need to be tempered by the risk of bias of included studies. Rigorously designed preclinical and clinical studies are warranted. Trial registration The review protocols were registered on PROSPERO (preclinical: CRD42019130896; clinical: CRD42019129513).

Serum salusins levels are increased and correlated positively with cyst size in ovarian endometrioma.

OBJECTIVES: The objective of this study is to evaluate plasma concentrations of salusin-α and salusin-ß levels in women with endometrioma and non-endometriotic benign ovarian cysts. METHOD: Endometrioma patients (n = 14), non-endometriotic ovarian cysts (n = 14), and age-matched normal healthy fertile subjects (n = 14) participated in this study. Plasma salusin-α and salusin-ß levels at the time of mid-luteal phase before and 3 months after L/S cystectomy were measured using ELISA and EIA tests, and their relation with demographic parameters was also assessed. RESULTS: The mean salusin-α and salusin-ß levels were significantly higher in women with endometrioma before the removal of cyst compared with cases with non-endometriotic cyst and fertile cases. Surgical removal of the endometrioma decreased the mean salusin-α and salusin-ß levels to the level of those with non-endometriotic cyst before and after the cystectomy and fertile women, in both unilateral and bilateral endometrioma cases. Plasma salusin-ß concentrations were found to be positively correlated with age, size of cyst, bilaterality, and salusin-α levels. Salusin-ß values showed no correlations to BMI and size of the ovarian cysts. CONCLUSIONS: Plasma salusin-α and salusin-ß levels are increased in endometrioma patients and positively correlated with endometrioma size. Laparoscopic removal of the endometrioma by stripping technique decreases the salusin levels to a similar level of fertile women.

Comparison of an ultrasound-guided technique versus a landmark-guided technique for internal jugular vein cannulation.

Central venous cannulation is a commonly preformed procedure in many branches of medicine, particularly in anaesthesia and intensive care medicine. The purpose of this study was to compare the landmark-guided technique to the ultrasound-guided technique for internal jugular vein cannulation in cardiovascular surgery patients. One hundred cardiovascular surgery patients, of whom 65 were male and 35 were female with ages ranging from 22 to 65, who had internal jugular cannulation between December 2010-March 2011 in our clinic were investigated prospectively. Patients were randomized into two groups; ultrasound guided internal jugular cannulation cases in group U (n=50), and anatomic landmark guided cases in group A (n=50). The number of attempts until successful catheterization, the time required for successful catheterization, arising complications, the demographics and the duration of catheterization were recorded for each patient. There were no significant differences found in the demographic features between the two groups. The number of attempts for successful catheterization was statistically lower in group U (1.1±0.5) than in group A (2.2±1.6). The time required for successful catheterization was statistically lower in group U (109.4±30.4) than in group A (165.9±91.5). There were no significant differences found in the total complications of the two groups (p=0.092). Four patients had an arterial punction [group U (n=0) and group A (n=4)] and two patients had a hematoma [group U (n=1) and group A (n=1)]. Arterial punction complication was increased significantly in landmark group (p=0.041). The findings of this study indicate that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of attempts.

Impact of luteal phase hysteroscopy and concurrent endometrial biopsy on subsequent IVF cycle outcome.

PURPOSE: Endometrial biopsy preceding implantation in in vitro fertilization (IVF) treatment causes a type of injury which facilitates implantation. Pre-treatment hysteroscopic evaluation of uterine cavity also raises the success in IVF. This study investigates whether office hysteroscopy and concurrent endometrial biopsy performed in the luteal phase, on the day of GnRH agonist initiation for long protocol, improves subsequent IVF outcome. METHODS: A prospective, nonrandomized, controlled study of 128 normoresponder women was performed: In 70 women (study group), office hysteroscopy and concurrent endometrial biopsy were performed on the day of GnRH agonist initiation preceding ET cycle and in 58 women (control group), GnRH agonist was initiated without any intervention. However, uterine cavity was shown to be normal with hysteroscopy within the previous 6 months in those women. Implantation and pregnancy rates were compared between the groups. RESULTS: Intrauterine pathologies were observed in 28 % of women in the study group. Implantation rate (38 vs. 25 %; p = 0.04) and pregnancy rate per ET (67 vs. 45 %; p = 0.01) were found to be significantly higher in the study group compared to the control group. CONCLUSION: Office hysteroscopy and concurrent endometrial biopsy performed in the luteal phase, on the day of GnRH agonist initiation for long protocol, provide direct evaluation of the uterine cavity immediately before ET cycle and also significantly improve the implantation and IVF outcome.

Does rocuronium-sugammadex reduce myalgia and headache after electroconvulsive therapy in patients with major depression?

BACKGROUND: We aimed to compare the effects of succinylcholine and rocuronium-sugammadex on development of myalgia and headache after electroconvulsive therapy (ECT). METHODS: Forty-five patients undergoing ECT were enrolled in the study. Anesthesia induction was provided with propofol 1 mg/kg intravenously (IV) + succinylcholine 1 mg/kg IV in group S (n = 24) and propofol 1 mg/kg IV + rocuronium 0.3 mg/kg IV in group R (n = 21). Sugammadex 4 mg/kg IV was administered to group R after the motor seizure. The first 3 ECT sessions were evaluated on the basis of time to onset of spontaneous respiration following the induction, time to eye-opening response to verbal stimuli, and visual analog scale (VAS) scores for myalgia and headache at hours 2, 6, 12, and 24 following the ECT for all patients. RESULTS: The times to onset of spontaneous respiration and eye-opening response to verbal stimuli were significantly shorter in all the 3 sessions in group R compared with group S (P < 0.002). Myalgia VAS scores at hours 2, 6, and 12 and the headache VAS scores at hours 2 and 6 were significantly higher in group S versus group R (P < 0,015). CONCLUSIONS: We concluded that the rates of myalgia and headache after ECT were significantly lower in group R than in group S, and also the awakening time (spontaneous respiration and opening the eyes in response to verbal stimuli) was significantly shorter in group R compared with group S.

A randomized controlled trial of preinsertion ultrasound guidance for spinal anaesthesia in pregnancy: outcomes among obese and lean parturients: ultrasound for spinal anesthesia in pregnancy.

PURPOSE: The present study was conducted to examine if preinsertion lumbar ultrasound scanning helps with performance of spinal puncture, as a tool for decreasing the number of puncture attempts and spinal procedure time and increasing the success rate. We hypothesized that ultrasound can facilitate neuraxial blockade, particularly in pregnant women with difficult topographic anatomy. METHODS: One hundred (50 lean, BMI <30 kg/m(2), and 50 obese, BMI ≥30 kg/m(2)) parturients scheduled for cesarean delivery were divided into ultrasound and control groups. Subarachnoid block was performed with prepuncture ultrasound examination in lean parturients (group 1, n = 25) and in obese parturients (group 2, n = 25), and subarachnoid block was performed without prepuncture ultrasound examination in lean parturients (group 3, n = 25) and in obese parturients (group 4, n = 25). The number of puncture attempts and puncture levels were recorded. RESULTS: A lower number of puncture attempts and fewer puncture levels were detected in ultrasound (US) groups (p < 0.001). First attempt success rate under US guidance was 92 % in comparison to 44 % using a conventional technique in obese parturients (p < 0.001). In 52 % of the lean patients and in 54.2 % of the obese patients, the intercristal line was at the L3-L4 and at the L2-L3 interspace, respectively. The duration of spinal procedure was shorter in US groups (22 vs. 52 s, p = 0.031). We found a high correlation between ultrasound and needle depth (r = 0.709, p < 0.001). CONCLUSIONS: We found a high level of success in the prepuncture ultrasound-determined insertion point. The ultrasound imaging technique can be a reliable guide to facilitate spinal anesthesia, especially in obese parturients.

Serum myeloperoxidase, paraoxonase, and plasma asprosin concentrations in patients with acute myocardial infarction.

Introduction: The objective of this study was to evaluate the usefulness of the serum biomarkers myeloperoxidase (MPO), paraoxonase (PON), and plasma asprosin in acute myocardial infarction (AMI) diagnosis and assess their compatibility with routinely screened cardiac biomarkers. Methods: This study was conducted using a prospective cross-sectional design and included 90 patients, consisting of 60 patients diagnosed with AMI (30 with ST-segment elevation and 30 with non-ST-segment elevation on ECG) and 30 controls (without a diagnosis of AMI). Changes in the levels of cardiac biomarkers (Hs-cTnI, CK, CK-MB), lipid profile (TC, TG, LDL, HDL), MPO, PON, asprosin, and routine biochemical parameters of patients were evaluated. Furthermore, receiver operating characteristic curve analysis revealed the diagnostic value of Hs-cTnI, MPO, PON, and asprosin in predicting AMI. Binary logistic regression analysis of cardiac marker concentrations was used to predict the presence of AMI. In contrast, multinomial logistic regression analysis was conducted to predict the type of AMI and the control group. Results: The median levels of MPO and plasma asprosin were found to be higher in the patient group (3.22 [interquartile range {IQR}: 2.4-4.4] ng/ml and 10.84 [IQR: 8.8-17.8] ng/ml, respectively) than in the control group (2.49 [IQR: 1.9-2.9] ng/ml and 4.82 [IQR: 4.6-8.0] ng/ml, respectively) (p = 0.001 and p < 0.001, respectively). The median levels of PON were 8.94 (IQR: 7.6-10.4) ng/ml in the patient group and 10.44 (IQR: 9.1-20.0) ng/ml in the control group (p < 0.001). In the binary logistic regression model, compared with the control group, a 1 ng/ml increase in MPO level increased the odds of having AMI by 3.61 (p = 0.041, 95% CI: 1.055-12.397), whereas a 1 ng/ml increase in asprosin level increased the odds of having AMI by 2.33 (p < 0.001, 95% CI: 1.479-3.683). In the multinominal logistic regression model, compared with the control group, a 1 ng/ml increase in the MPO level increased the odds of having NSTEMI by 4.14 (p = 0.025, 95% CI: 1.195-14.350), whereas a 1 ng/ml increase in asprosin concentrations increased the odds of having NSTEMI by 2.35 (p < 0.001, 95% CI: 1.494-3.721). Conclusion: Herein, MPO and asprosin concentrations increased with Hs-cTnI, and a decrease in PON concentration indicated that oxidant-antioxidant parameters and adipokines were related to AMI pathogenesis.

Ultrasound-guided transversus abdominis plane block in children: a randomised comparison with wound infiltration.

CONTEXT: The transversus abdominis plane (TAP) block is a new regional anaesthesia technique applicable to infants and children. OBJECTIVE(S): The present study was designed to evaluate the analgesic efficacy of ultrasound-guided TAP block with high volume local anaesthetic (0.5  ml kg) during the first 24 h after surgery in children undergoing inguinal hernia repair. DESIGN: Randomised comparative study. SETTING: Gaziantep University Hospital between December 2010 and May 2011. PATIENTS OR OTHER PARTICIPANTS: Fifty-seven children between 2 and 8 years of age undergoing unilateral inguinal hernia repair were randomised to TAP block (group T, n = 29) or to wound infiltration (group C, n = 28). INTERVENTION(S): A TAP block using ultrasound guidance with 0.25% levobupivacaine 0.5  ml kg(-1) or wound infiltration with 0.2  ml kg(-1) 0.25% levobupivacaine, was performed on the same side as the hernia under general anaesthesia. MAIN OUTCOME MEASURES: Time to first analgesic, cumulative number of doses of analgesic, pain scores and adverse effects were assessed over the course of 24  h. RESULTS: The time to first analgesic (mean ±â€ŠSD) was significantly longer in group T than in group C (17 ±â€Š6.8 vs. 4.7 ±â€Š1.6 h, respectively; P < 0.001). Thirteen (45%) patients in group T did not require any analgesic within the first 24 h. The cumulative number of doses of analgesic was significantly lower in group T than in group C (1.3 ±â€Š1.2 vs. 3.6 ±â€Š0.7, respectively, P < 0.001). Pain scores were significantly different between the groups at all time points except at 1, 20 and 24  h (P < 0.001). CONCLUSION: Ultrasound-guided TAP block with high volume (0.5 ml kg) 0.25% levobupivacaine provides prolonged postoperative analgesia and reduced analgesic use without any clinical side-effects after unilateral hernia repair in children. TRIAL REGISTRATION: ACTRN12611000585921 (7/06/2011) from Australian New Zealand Clinical Trials Registry.

Recurrent spontaneous ovarian hyperstimulation in a virgin girl.

Ovarian hyperstimulation syndrome (OHSS) develops due to the release of vasoactive mediators induced by excessively luteinized and enlarged ovaries. Most OHSS cases are iatrogenic subsequent to ovulation induction. We report the first case of recurrent OHSS developed during normal menstral cycle in a virgin girl, diagnosed with ultrasonography and magnetic resonance imaging.

A comparison of different volumes of bupivacaine used in fascia iliaca compartment block introduction.

BACKGROUND: Fascia iliaca compartment block (FICB) is one of the regional techniques applied for post-operative pain control after femoral and knee surgery. To the best of our knowledge, there are limited reports focusing on local anesthetic (LA) volume. Our aim in this study was to find the most clinically effective volume by comparing three different volumes of LA used frequently in the literature for US-guided infra-inguinal FICB for post-operative pain control in patients undergoing femur and knee surgery. METHODS: A total of 45 patients with ASA I-III physical scores were included in the study. When the surgical procedure was completed under general anesthesia, FIKB was applied with 0.25% Bupivacaine under ultrasound guidance to the patients before extu-bation. Patients were randomly divided into three different groups for the volume of local anesthetic to be administered. Bupivacaine was administered 0.3 mL/kg in Group 1, 0.4 mL/kg in Group 2 and 0.5 mL/kg in Group 3. After FIKB, the patients were extubated. The patients were followed up for 24 h postoperatively in terms of vital signs, pain scores, additional analgesic requirement, and possible side effects. RESULTS: When the post-operative pain scores were compared, the scores of Group 1 were found to be statistically higher than Group 3 at the post-operative 1st, 4th, and 6th h (p<0.05). When the additional analgesia requirement compared, the post-operative 4th h was highest in Group 1 compared to the other groups (p=0.03). At the post-operative 6th h, additional analgesic requirement was less in Group 3 than in the other groups, and there was no difference between Groups 1 and 2 (p=0.026). As the LA volume increased, the amount of analgesic consumed in the first 24 h decreased, but there was no statistically significant difference (p=0.051). CONCLUSION: Our study showed that ultrasound-guided FIKB is a safe and effective method for post-operative pain relief as a part of multimodal analgesic components, and 0.25% bupivacaine in 0.5 mL/kg volume provides more effective analgesia than the other two groups without any side effects.

Protective Effect of Hydrogen-Rich Saline on Spinal Cord Damage in Rats.

The anti-inflammatory and anti-apoptotic effects of molecular hydrogen, delivered as hydrogen-rich saline (HRS), on spinal cord injury was investigated. Four-month-old male Sprague Dawley rats (n = 24) were classified into four groups: (1) control-laminectomy only at T7-T10; (2) spinal injury-dura left intact, Tator and Rivlin clip compression model applied to the spinal cord for 1 min, no treatment given; (3) HRS group-applied intraperitoneally (i.p.) for seven days; and (4) spinal injury-HRS administered i.p. for seven days after laminectomy at T7-T10 level, leaving the dura intact and applying the Tator and Rivlin clip compression model to the spinal cord for 1 min. Levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were measured in blood taken at day seven from all groups, and hematoxylin-eosin (H & E) and terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) were used to stain the tissue samples. IL-6 and TNF-α levels were significantly lower in the group treated with HRS following the spinal cord injury compared to the group whose spinal cord was damaged. A decrease in apoptosis was also observed. The anti-inflammatory and anti-apoptotic effect of IL-6 may be a clinically useful adjuvant therapy after spinal cord injury.

The effect of N95 respirators on vital parameters, PETCO2, among healthcare providers at the pandemic clinics.

BACKGROUND: Wearing face shields and masks, which used to have very limited public use before the COVID-19 outbreak, has been highly recommended by organizations, such as CDC and WHO, during this pandemic period. AIMS: The aim of this prospective study is to scrutinize the dynamic changes in vital parameters, change in end tidal CO2 (PETCO2) levels, the relationship of these changes with taking a break, and the subjective complaints caused by respiratory protection, while healthcare providers are performing their duties with the N95 mask. METHODS: The prospective cohort included 54 healthcare workers (doctors, nurses, paramedics) who worked in the respiratory unit of the emergency department (ED) and performed their duties by wearing valved N95 masks and face shields. The vital parameters and PETCO2 levels were measured at 0-4th-5th and 9th hours of the work-shift. RESULTS: Only the decrease in diastolic BP between 0 and 9 h was statistically significant (p = 0.038). Besides, mean arterial pressure (MAP) values indicated a significant decrease between 0-9 h and 5-9 h (p = 0.024 and p = 0.049, respectively). In terms of the vital parameters of the subjects working with and without breaks, only PETCO2 levels of those working uninterruptedly increased significantly at the 4th hour in comparison to the beginning-of-shift baseline levels (p = 0.003). CONCLUSION: Although the decrease in systolic blood pressure (SBP) and MAP values is assumed to be caused by increased fatigue due to workload and work pace as well as increase in muscle activity, the increase in PETCO2 levels in the ED healthcare staff working with no breaks between 0 and 4 h should be noted in terms of PPE-induced hypoventilation.

Two unusual clinical presentations of broad-ligament leiomyomas: a report of two cases.

We report on two unusual clinical presentations of broad-ligament leiomyomas. The first case was a combination of broad-ligament leiomyoma and ectopic gestational sac at the same location. The other case was a broad-ligament leiomyoma presenting as an ovarian malignancy. The differential diagnosis of broad-ligament leiomyoma should be considered in cases of an adnexal mass. Additionally, a broad-ligament leiomyoma could be the reason for an ectopic pregnancy.

The effects of dragon fruit (Hylocereus polyrhizus) extract on indomethacin-induced stomach ulcer in rats.

The aim of this study was to investigate the effects of red dragon fruit (Hylocereus polyrhizus) extract (DFE) on the stomach in ulcer model induced by indomethacin in rats. Effects of DFE were evaluated in indomethacin-induced gastric damage model on Sprague-Dawley rats. Experimental model: all rats were fasted for 24 h. At the end of this period, DFE was administered to the ulcer-induced groups. One hour after this application, a dose of 25 mg/kg of indomethacin was applied by oral gavage to all groups except the HEALTHY and DFE1000 groups. Six hours after indomethacin administration, the rats were euthanized with high-dose anesthesia and the experiment was terminated. Macroscopic and microscopic analyses for investigating ulcerative area, molecular and biochemical analyses for oxidative damages investigation and molecular analyses for the effect mechanism of indomethacin and DFE were conducted on stomach tissues in the study. While oxidative stress-associated markers such as MDA, BAX, and Caspase 3 increased dramatically in the indomethacin group, GSH antioxidant levels decreased. It was observed that these parameters were significantly improved in DFE 500 mg/kg and DFE 1000 mg/kg groups compared to ulcer group, and the results of especially DFE 1000 mg/kg group were similar to famotidine group. We observed that our histopathological findings also supported all our other findings. Dragon fruit extract was protected against indomethacin-induced ulcer damage by decreased MDA levels, increased GSH levels, and inhibition of Caspase 3, BAX, and Cox-2, and activation of Cox-1. PRACTICAL APPLICATIONS: People of all ages around the world suffer from gastric ulcer which is one of the most common gastrointestinal ailments. The etiological factors of the disease are using of cigarette and alcohol, nutritional deficiencies, infections, and using non-steroidal anti-inflammatory drugs which use frequent and indiscriminate. Indomethacin is one of the NSAIDs and is commonly preferred to induce ulcer modeling in rats due to its gastric toxicity potential. Current anti-ulcer drugs have many serious side effects. Patients who suffered from gastric ulcer tend to discontinue the drug because of side effects. Therefore, patients need new agents that are non-toxic, have few side effects, and are easily accessible anti-ulcer drugs. Dragon fruit, as a medicinal herb, is highly valuable and widely used in traditional medicine, and may provide gastroprotective activity. Studies have shown that H. polyrhizus has antioxidant activities. We consider the effects of dragon fruit extract (DFE) to be a therapeutic drug for an indomethacin-induced ulcer model.

Ultrasound-guided infraclavicular brachial plexus block enhances postoperative blood flow in arteriovenous fistulas.

OBJECTIVE: Brachial plexus block offers several advantages when creating vascular access for hemodialysis. However, no controlled studies have directly evaluated arteriovenous fistula (AVF) blood flow in patients anesthetized by this method. We compared the effects of ultrasound-guided, infraclavicular brachial plexus block and local infiltration anesthesia on blood flow in the radial artery and AVF during the early and late postoperative periods. METHODS: Sixty patients were randomly assigned to an experimental group, which received infraclavicular brachial plexus block (IB), or to a control (C) group that received local infiltration anesthesia. Blood flow in the distal radial artery was measured before and after IB or infiltration anesthesia. AVF flow during the early and late postoperative period was evaluated using duplex ultrasound imaging. The rates of primary fistula failure were also compared. RESULTS: After anesthesia, preoperative radial arterial flow was 56 ± 8.6 mL/min in group IB vs 40.7 ± 6.11 mL/min in group C (P < .0001). Blood flow in the fistula, measured in mL/min at 3 hours, 7 days, and 8 weeks postoperatively, was also greater in group 1B vs group C, respectively, at 69.6 ± 7.9 vs 44.8 ± 13.8 (P < .001), 210.6 ± 30.9 vs 129 ± 36.1 (P < .001), and 680.6 ± 96.7 vs 405.3 ± 76.2 (P < 0.001). CONCLUSION: When used for AVF access surgery, infraclavicular brachial plexus block provides higher blood flow in the radial artery and AVF than is achieved with infiltration anesthesia.

Comparison of the effects of low-flow and high-flow inhalational anaesthesia with nitrous oxide and desflurane on mucociliary activity and pulmonary function tests.

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the effects of inhalational anaesthesia using low and high gas flow rates of nitrous oxide and desflurane on mucociliary clearance and pulmonary function. METHODS: Fifty adult patients of the American Society of Anesthesiologists physical status I-II, aged between 18 and 70 years, were recruited to the study. Patients were assigned randomly to one of two study groups. The fresh gas flow rate was 1 l min(-1) (0.5 l min(-1) O2 + 0.5 l min(-1) N2O + desflurane) in group 1 and 3 l min(-1) (1.5 l min(-1) O2 + 1.5 l min(-1) N2O + desflurane) in group 2. Patients' haemodynamic parameters and changes in the humidity and temperature of the inspired gases were recorded and the saccharin clearance time was measured before and after anaesthesia. Respiratory parameters, body temperature, end-tidal CO2 concentration and inspired and expired oxygen and nitrous oxide concentrations were also recorded. RESULTS: The forced vital capacity and forced expiratory volume in 1 s were significantly lower and the saccharin clearance time was significantly longer in group 2 compared to group 1 (P < 0.05). There were statistically significant differences between the groups regarding the humidity and temperature of the inspired gases (P < 0.05). CONCLUSION: Respiratory function and mucociliary clearance are better preserved in a low-flow anaesthesia technique than in high-flow anaesthesia with nitrous oxide and desflurane. Therefore, a low-flow anaesthesia technique with nitrous oxide and desflurane may provide an important clinical advantage because it provides appropriately heated and humidified gases to the tracheobronchial tree.

How is electrocardiogram influenced by electroconvulsive therapy in males and females?

OBJECTIVES: We aimed to investigate and compare the P duration and P dispersion (Pd) between male and female patients with a primary diagnosis of chronic schizophrenia disorder before and after the electroconvulsive therapy (ECT) period. METHODS: We obtained electrocardiograms of 50 healthy young volunteers which included 25 female (group F, n = 25) and 25 male patients (group M, n = 25). We measured minimum and maximum P wave durations (Pmin, Pmax) and Pd in milliseconds. Electrocardiography was performed before electroconvulsive therapy (ECT) and immediately after the ECT period after awakening. A 12-lead surface electrocardiogram was obtained from each subject in the supine position. RESULTS: The post-ECT P duration was significantly longer than the pre-ECT P duration in groups F and M (P = 0.01 and P = 0.008, respectively). The post-ECT Pd was significantly longer than the pre-ECT Pd in groups F and M (P = 0.0001 in both groups). A higher correlation (r) in group M was observed between the pre-ECT Pd and post-ECT P duration than in group F (r = 0.538, P = 006 in group M; r = 0.349, P = 08 in group F). There was no significant difference between the groups regarding hemodynamics. CONCLUSIONS: Electroconvulsive therapy in both sexes may influence atrial conduction as evidenced by the significantly prolonged Pmax and Pd in patients with a primary diagnosis of schizophrenia disorder.

Experimental demonstration of a concave grating for spin waves in the Rowland arrangement.

We experimentally demonstrate the operation of a Rowland-type concave grating for spin waves, with potential application as a microwave spectrometer. In this device geometry, spin waves are coherently excited on a diffraction grating and form an interference pattern that focuses spin waves to a point corresponding to their frequency. The diffraction grating was created by focused-ion-beam irradiation, which was found to locally eliminate the ferrimagnetic properties of YIG, without removing the material. We found that in our experiments spin waves were created by an indirect excitation mechanism, by exploiting nonlinear resonance between the grating and the coplanar waveguide. Although our demonstration does not include separation of multiple frequency components, since this is not possible if the nonlinear excitation mechanism is used, we believe that using linear excitation the same device geometry could be used as a spectrometer. Our work paves the way for complex spin-wave optic devices-chips that replicate the functionality of integrated optical devices on a chip-scale.